<?php echo form_open($this->config->item('admin_folder').'/customers/form/'.$id); ?>
	<div class="row">
		<div class="span3">
			<label><?php echo lang('company');?></label>
			<?php
			$data	= array('name'=>'company', 'value'=>set_value('company', $company), 'class'=>'span3');
			echo form_input($data); ?>
		</div>
	</div>

	<div class="row">
        <div class="span6">
        	<label>Full name</label>
            <?php
			$data	= array('name'=>'fullname', 'value'=>set_value('fullname', $fullname), 'class'=>'span6');
			echo form_input($data); ?>
        </div>
    </div>
    
   	<div class="row">
        <div class="span6">
        	<label>Ngày sinh</label>
            <?php
			$data	= array('name'=>'birth', 'value'=>set_value('birth', $birth), 'class'=>'span6');
			echo form_input($data); ?>
        </div>
    </div>

	<div class="row">
		<div class="span3">
			<label><?php echo lang('email');?></label>
			<?php
			$data	= array('name'=>'email', 'value'=>set_value('email', $email), 'class'=>'span3');
			echo form_input($data); ?>
		</div>
		<div class="span3">
			<label><?php echo lang('phone');?></label>
			<?php
			$data	= array('name'=>'phone', 'value'=>set_value('phone', $phone), 'class'=>'span3');
			echo form_input($data); ?>
		</div>
	</div>

	<div class="row">
		<div class="span3">
			<label><?php echo lang('password');?></label>
			<?php
			$data	= array('name'=>'password', 'class'=>'span3');
			echo form_password($data); ?>
		</div>
		<div class="span3">
			<label><?php echo lang('confirm');?></label>
			<?php
			$data	= array('name'=>'confirm', 'class'=>'span3');
			echo form_password($data); ?>
		</div>
	</div>

	<div class="row">
        <div class="span6">
        	<label>Thông tin thêm về công ty</label>
            <?php
			$data	= array('name'=>'other_infomation', 'value'=>set_value('other_infomation', $other_infomation), 'class'=>'span6');
			echo form_textarea($data); ?>
        </div>
    </div>

	<div class="row">
		<div class="span3">
			<label class="checkbox">
			<?php $data	= array('name'=>'email_subscribe', 'value'=>1, 'checked'=>(bool)$email_subscribe);
			echo form_checkbox($data).' '.lang('email_subscribed'); ?>
			</label>
		</div>
	</div>

	<div class="row">
		<div class="span3">
			<label class="checkbox">
				<?php
				$data	= array('name'=>'active', 'value'=>1, 'checked'=>$active);
				echo form_checkbox($data).' '.lang('active'); ?>
			</label>
		</div>
	</div>

	<div class="row">
		<div class="span3">
			<label><?php echo lang('group');?></label>
			<?php echo form_dropdown('group_id', $group_list, set_value('group_id',$group_id), 'class="span3"'); ?>
		</div>
	</div>
    <?php if(!empty($image)){?>
    <div class="row">
    	<div class="span12">
            <label>Hình ảnh công ty: </label>
            <?php foreach($image as $index=>$val){$url_image = base_url("uploads/images/small/agency/".$val)?>
            <ul style="margin:0px;padding:0px">
                <li style="margin-right:20px;float:left;list-style:none"> <img width="150" src="<?php echo $url_image ?>" /></li>
            </ul>
            <?php }?>
        </div>
    </div>
    <?php }?>

	<div class="form-actions">
		<input class="btn btn-primary" type="submit" value="<?php echo lang('save');?>"/>
	</div>
</form>